Can insurance pay my cataract programme co-payment?

HA invites patients in batches from its routine cataract surgery waiting lists, giving priority to longer waits. Invitation criteria include suitability for local anaesthesia; urgent and early cases remain handled by HA rather than this private-treatment option. Confirm your invitation and arrangements with HA before booking. Being on a waiting list does not itself establish a private insurance benefit. [C1, C9]

The package includes a pre-operative assessment, cataract surgery with a basic monofocal intraocular lens and medical consumables, and 2 post-operative checks. HA states a subsidy of HK$8,000 and a patient co-payment of up to HK$8,000; the package fee cannot exceed HK$16,000. HA pays its subsidy directly to the ophthalmologist. These are programme arrangements, not a quotation for your treatment or an insurance benefit limit. [C1]

A different type of intraocular lens attracts an additional fee agreed with the ophthalmologist. Ask for a written breakdown distinguishing the package and additional charges. Waiver Eligible Patients may approach participating ophthalmologists who agree to provide surgery without co-payment; the relevant list accompanies the invitation. Confirm waiver status and the chosen doctor’s arrangements rather than assuming every participant pays nothing. [C1]

HA explains that patients can use the normal medical-insurance claim procedure for payments made, according to the individual policy. Send the proposed package and any additional lens charge to the insurer through its approved channel. Ask which charges are covered, what approval or documents are needed, and what you must bear yourself. Eligibility for the public programme is separate from contractual reimbursement. Ask a licensed broker about unclear policy terms. [C1, C9]

Does HA invitation guarantee insurance payment?

No. Insurance reimbursement remains subject to the individual policy. [C1]

Is the HA subsidy paid into my account?

HA says the subsidy is paid directly to the private ophthalmologist. [C1]

What is the package fee ceiling?

HA states HK$16,000, with HK$8,000 subsidy and co-payment up to HK$8,000. [C1]

Are follow-up checks included?

The package includes 2 post-operative checks. [C1]

Is every lens included in the package?

The package includes a basic monofocal lens; a different type has an additional agreed charge. [C1]

Can waiver-eligible patients choose any doctor free of charge?

Use the list of participating ophthalmologists offering the waiver arrangement and confirm the details. [C1]

Can I claim the whole package as my own expense?

Identify what you actually paid and disclose the subsidy; ask the insurer to assess eligible expenses under your policy. [C1, C9]

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We provide information and referrals to a licensed Hong Kong broker; regulated advice and arrangements belong with that broker. Mainland visitors must sign in Hong Kong. Do not send identity, tax or medical documents through the general enquiry form. [C9]

General information, not advice.